Mycophenolate mofetil is an immunosuppressive drug that has recently been used to treat autoimmune and inflammatory skin diseases.1,2 We herein report the first case of lichen planus (LP) successfully treated with mycophenolate.

A 55-year-old white woman with a 10-year history of LP of the lower extremities presented for a therapeutic alternative. Prior treatments included several courses of tapered oral and topical steroids, including a 9-week course of flurandrenolide tape applied nightly, psoralen–UV-A, hydroxychloroquine sulfate (400 mg/d for 10 months), azathioprine (150 mg/d for 8 months), and methotrexate (15 mg/wk for 7 months), none of which led to sustained improvement. On physical examination, she had multiple hypertrophic scaly papules and plaques on the pretibial areas bilaterally, some of which were ulcerated. On the medial aspects of the feet, she had violaceous bullous plaques. No mucosal lesions were present. Histological examination of the hypertrophic and bullous lesions demonstrated changes characteristic of LP.